Bipolar sealer not superior to standard electrocautery in primary total hip arthroplasty: a meta-analysis.

Yang Y, Zhang LC, Xu F, Li J, Lv YM - J Orthop Surg Res (2014)

Bottom Line:
The use of bipolar sealer did not significantly reduce intraoperative blood loss, hemoglobin drop, hospital stay, and operative time.There were no significant differences in need for transfusion and the incidence of infection between the study groups.The use of bipolar sealer is not recommended in primary THA.

Methods: All studies published through November 2013 were systematically searched in PubMed, Embase, ScienceDirect, The Cochrane Library, and other databases. Relevant journals or conference proceedings were searched manually. Only randomized controlled trials were included. Two independent reviewers identified and assessed the literature. Mean difference in blood loss and risk ratios of transfusion rates and of complication rates in the bipolar sealer group versus the standard electrocautery group were calculated. The meta-analysis was conducted using RevMan 5.1 software.

Results: Five studies were included, with a total sample size of 559 patients. The use of bipolar sealer did not significantly reduce intraoperative blood loss, hemoglobin drop, hospital stay, and operative time. There were no significant differences in need for transfusion and the incidence of infection between the study groups.

Conclusion: The available evidence suggests that the use of bipolar sealer was not superior to standard electrocautery in patients undergoing primary THA. The use of bipolar sealer is not recommended in primary THA.

Fig3: Risk of bias. Each risk-of-bias item presented as percentages across all included studies, which indicated the proportion of different levels of risk of bias for each item.

Mentions:
We identified a total of 16 citations as potentially relevant. By screening the title, and reading the abstract and the entire article, we found that five RCTs enrolling a total of 559 hips at final follow-up were eligible for data extraction and meta-analysis [17-21] (Figure 1). The sample size for each study ranged from 50 to 200. Studies were relatively well designed, and the quality assessment score was high. However, the relevant RCTs had a number of methodological weaknesses (Figures 2 and 3).Figure 2

Fig3: Risk of bias. Each risk-of-bias item presented as percentages across all included studies, which indicated the proportion of different levels of risk of bias for each item.

Mentions:
We identified a total of 16 citations as potentially relevant. By screening the title, and reading the abstract and the entire article, we found that five RCTs enrolling a total of 559 hips at final follow-up were eligible for data extraction and meta-analysis [17-21] (Figure 1). The sample size for each study ranged from 50 to 200. Studies were relatively well designed, and the quality assessment score was high. However, the relevant RCTs had a number of methodological weaknesses (Figures 2 and 3).Figure 2

Bottom Line:
The use of bipolar sealer did not significantly reduce intraoperative blood loss, hemoglobin drop, hospital stay, and operative time.There were no significant differences in need for transfusion and the incidence of infection between the study groups.The use of bipolar sealer is not recommended in primary THA.

Methods: All studies published through November 2013 were systematically searched in PubMed, Embase, ScienceDirect, The Cochrane Library, and other databases. Relevant journals or conference proceedings were searched manually. Only randomized controlled trials were included. Two independent reviewers identified and assessed the literature. Mean difference in blood loss and risk ratios of transfusion rates and of complication rates in the bipolar sealer group versus the standard electrocautery group were calculated. The meta-analysis was conducted using RevMan 5.1 software.

Results: Five studies were included, with a total sample size of 559 patients. The use of bipolar sealer did not significantly reduce intraoperative blood loss, hemoglobin drop, hospital stay, and operative time. There were no significant differences in need for transfusion and the incidence of infection between the study groups.

Conclusion: The available evidence suggests that the use of bipolar sealer was not superior to standard electrocautery in patients undergoing primary THA. The use of bipolar sealer is not recommended in primary THA.